David, a student from an accredited HIM program, was given a professional practice experience project that required him
Posted: Wed Apr 20, 2022 8:43 am
David, a student from an accredited HIM program, was given a
professional practice experience project that required him to
review reimbursement denials for Medicare patients over the course
of the past year. He noticed that the denials were higher when the
claim included services from the radiology department. He
researched the claims and resubmitted them with additional
documentation. Through this process, he discovered that the
additional documents required were similar for each claim. Also,
because of the settings on the organization’s EHR, the required
diagnosis codes for the radiological services performed were not
being submitted on the claim form, although the procedure code was
included on the claim. David communicated his findings to the
manager, and they discussed potential next steps.
1) Which departments are responsible for the revenue cycle
problems at Community Health Clinic?
professional practice experience project that required him to
review reimbursement denials for Medicare patients over the course
of the past year. He noticed that the denials were higher when the
claim included services from the radiology department. He
researched the claims and resubmitted them with additional
documentation. Through this process, he discovered that the
additional documents required were similar for each claim. Also,
because of the settings on the organization’s EHR, the required
diagnosis codes for the radiological services performed were not
being submitted on the claim form, although the procedure code was
included on the claim. David communicated his findings to the
manager, and they discussed potential next steps.
1) Which departments are responsible for the revenue cycle
problems at Community Health Clinic?